Attachment_-_Request_for_Substitution_-_Exemption.pdf
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- Solicitation number
- RFQu-26-0091
- Issued by
- Maricopa County, Phoenix City, Arizona
About this file
This is a Request for Substitution/Exemption form from the City of Phoenix Public Transit Department Compliance Section used to request approval for changes to Disadvantaged Business Enterprise (DBE) utilization on public transit contracts. The form allows prime contractors to request exemptions or modifications to their DBE participation commitments, including releasing proposed DBE subcontractors, substituting DBE subcontractors, changing the scope of work for DBE subcontractors, or reducing amounts originally proposed for DBE participation. Prime contractors must submit the form to ptdcompliance@phoenix.gov prior to implementing any changes and must document good faith efforts to find additional DBE participation. The form requires authorization signatures from duly authorized representatives of the prime contractor and includes sections for the contractor to summarize their exemption request and supporting documentation. The City's Contract Compliance Section reviews and approves requests, noting the revised DBE goal and utilization percentages and indicating whether the request is approved.
The form directly relates to the City of Phoenix Finance Department's RFQu-26-0091 procurement for acquisition, relocation, and related real estate services, which requires contractors working on Federal Transit Administration (FTA)-assisted projects to comply with DBE and Small Business Participation Plan requirements under 49 CFR Part 26. Contractors must submit an initial DBE plan within 30 calendar days of contract award and provide annual updates, track and report all DBE and small business participation monthly through the City's Certification and Compliance System, and maintain comprehensive documentation of all participating vendors. This substitution/exemption process provides the mechanism through which contractors can request modifications to their DBE commitments after contract award, subject to City approval and demonstration of good faith efforts to maintain or increase DBE participation.
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Text version
City of Phoenix
PUBLIC TRANSIT DEPARTMENT
REQUEST FOR SUBSTITUTION/EXEMPTION
This form must be submitted to the City of Phoenix, Public Transit Department Compliance Section (ptdcompliance@phoenix.gov), for approval prior to making any changes to the proposed statement of DBE utilization or Contractor’s monthly statement of DBE utilization form. No DBE shall be substituted or terminated, nor shall their scope of work be reduced or proposed amount changed without the approval of the Compliance Section.
Prime Contractor: Contract Number:
Project Number and Description:
Affected DBE Subcontractor(s):
Scope of Work to be Performed by Affected DBE Subcontractors(s):
1. I am the duly authorized representative of the above listed Prime Contractor and am authorized to request this exemption on behalf of the Prime Contractor.
2. I hereby request that an exemption be granted to the above-mentioned Prime Contractor to (check those that apply):
Release proposed DBE subcontractor Substitute DBE subcontractor
Change scope of work to be performed by DBE subcontractor
Reduce amount originally proposed for DBE subcontractor
3. I have summarized the Prime Contractor's request for an exemption and the good faith efforts required in finding additional DBE participation on the above-mentioned contract as follows: (Attach additional pages and supporting documentation as necessary.)
Date:
Phone:
Yes No %
Date:
Authorized Signature:
Signature of Authorized Agent for Contractor
Name and Title:
FOR CONTRACT COMPLIANCE USE ONLY
Request Approved: Revised DBE Goal:
Revised DBE Utilization:
Contract Compliance Specialist:
| Exhibit - Initial SBPP Plan |
| Exhibit - DBE Annual SBPP Plan |
| Exhibit - DBE Request for Substitution or Exemption |
| Exhibit - DBE Certification of Final Payment |
| Phone: |
| Prime Contractor: |
| Contract Number: |
| Project Number and Description: |
| Affected DBE Subcontractors: |
| Scope of Work to be Performed by Affected DBE Subcontractorss: |
| to check those that apply: |
| Substitute DBE subcontractor: |
| undefined: |
| proposed for DBE: |
| follows Attach additional pages and supporting documentation as necessary: |
| Name and Title: |
| FOR CONTRACT COMPLIANCE USE ONLY: |
| No: |
| Date_2: |
| Text39: |
| Text40: |
| Text41: |
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